"BLUE DOG DEMOCRATS" COULD ALSO BE CALLED "BLUE ELEPHANTS"

The "Blue Dogs" seem to be even more confused than the GOP.

...The Official Logo of the "Blue Dog Democrats"

It´s taken well over a decade, but the Democrats are finally in control of the US Congress.

But now, after being confined for all those years out in the political desert, to have the so called "Blue Dog Democrats" turn on both their own party and those voters that put them in power, it´s now become a very confusing and disturbing situation. And this is all occurring while both political parties are having to deal with the most critical social issue of our time; "real US health care reform".

Today, 72% of the American public "want real US health care reform".

It has also become common knowledge that the so called "CO-OP" health insurance option that´s being discussed would not have the necessary negotiating power needed for generating the lower premium prices against the private health care companies. And to just do nothing and to stay with the "status quo" of the nation´s current "non-health care plan" would eventually become health care suicide for the majority of Americans.

Now today, the "Blue Dogs" are correct to hold President Obama and the Democratic leaders to their commitment for real health care cost control. However, they are totally off base in thinking that a goal of cost control conflicts with a national public health insurance plan for all Americans below the age of retirement.

In fact, if a plan were set up for working along with Medicare, it would be Congress's single most powerful tool for properly reforming how health care is paid for and delivered. With the appropriate authority, it could encourage private plans to develop innovations in payment and care coordination that could spread through the private insurance sector. This is just as have other past private / public-sector innovations such as the US Postal Service versus the private companies of UPS & FedEx.

The main Blue Dog issue is that the Congressional Budget Office (CBO) has stated that the current proposed bills on Capitol Hill won't bring down future medical cost inflation. Of course, the CBO report does not take fully into account the kinds of changes in health care costs that would occur with the implementation of a real public plan.

The pure irony is that the Blue Dogs' feel that a public plan, designed to compete with private insurers should be smaller and less powerful than the one proposed. But at the same time, they feel that Medicare and this new plan should pay more generous rates to their rural providers….? Of course, this increase in payment rates would make their idea of reform even more expensive, not less.

The further irony is that the public plan that the Blue Dogs worry is too costly is the best reform that would make health-care affordable for a very large share of the Blue Dogs´ own constituents.

Offering public plan rates at close to Medicare levels while giving doctors and hospitals the choice of accepting them, as the proposed House legislation does, is a way to test the market. If providers accept the rates, as the CBO has projected they will, the Blue Dogs will get what they want in the form of lower costs. If not, the bill in the House contains provisions for adjusting the rates, including nearly $10 billion to raise rates in rural areas if an independent study determines that higher rates are actually needed.

While many Blue Dogs are concerned about a "too large" public plan, the CBO currently projects that most working Americans will still have coverage from their employers and the new public plan will only cover ~5% of the population.

In addition, by providing a plan that competes with private insurers, the public plan will broaden health care coverage while encouraging private plans to reduce their premiums. That's why the support for a public plan is as high in the very conservative rural areas as it is nationwide, with 72% of all voters expressing strong support.

A public health plan would be vital for Americans in the rural areas that many Blue Dogs represent. Today, these rural regions feature both limited insurance competition and shockingly large numbers of residents without coverage or with inadequate coverage.

However, as with the GOP, so far the Blue Dogs have mostly ignored the huge benefits of a new public plan for their specific districts. They have also largely ignored the disproportionate benefits promised by the plans new federal subsidies for low- and medium-income workers.

Today, large numbers of farmers, ranchers and self-employed workers can barely afford a policy in the individual private market or they are totally uninsured. These groups would benefit greatly from the assistance in the promised House legislation for workers whose earnings are up to 400% above the current poverty line.

There will also be additional subsidies for small businesses to cover their workers from a new national purchasing pool, or "exchange", giving those employers access to low-cost group health insurance that's currently out of reach.

Given that the Blue Dogs are worried about the federal cost of reform, they should applaud the House bill's requirement that all but the smallest of employers will be making a meaningful contribution to the cost of health care coverage. This will ensure that most employers will be contributing to the cost of the insurance. It will also reduce the incentive for employers to drop health care coverage and it will let their workers go into the public pool, increasing the size of the exchange and the overall public plan.

The Blue Dog Democrats currently have the future of US health-care reform in their hands.

If they hold firm to their principles of fiscal responsibility and effective relief for the workers and employers in their districts, what's good for the Blue Dogs will also be good for all Americans.

Copyright G.Ater 2009

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